Regulatory Alerts2020-01-20
Data Management, Claims and Complaints
The regulator mandates that insurers implement effective, proportionate frameworks for data, claims, and complaints management tailored to their specific business models. These systems must ensure accurate, accessible policyholder records, enforce end-to-end claims processing with strict timeframes and fraud controls, and maintain detailed complaint registers tracking resolutions, compensation, and ombud referrals. Furthermore, insurers are prohibited from imposing unreasonable post-sale barriers or denying claims solely based on polygraph results, while ensuring transparent reporting to executive leadership and compliance with privacy legislation.
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